Background:Diabetic foot results in considerable morbidity and mortality in developing countries and the prevalence of diabetes is expected to increase further in the next decades in these countries. Diabetic ulcers are the most common foot injuries leading to lower extremity amputation. Family physicians have a pivotal role in the prevention or early diagnosis of diabetic foot complications. Patient education regarding foot hygiene, nail care and proper footwear is crucial to reducing the risk of an injury that can lead to ulcer formation.Materials and Methods:This is a prospective study carried out from July 2013 to September 2015. Fifty patients of Diabetes with foot ulcer and two hundred without foot ulcers were examined. Risk factors and clinical profile of patients were studied which included age, gender, duration of diabetes, BMI, smoking, random BSLs history, hypertension, glycated haemoglobin levels, lipid profile, history of loss of sensation and history of amputation. MNSI questionnaire and MNSI practical assessment for neuropathy were administered to diabetic patients along with a pre-structured questionnaire regarding foot care practices.Results:In this study significant risk factors were peripheral neuropathy, peripheral vascular disease, gender, loss of sensation, duration of diabetes and smoking. MNSI questionnaire and practical assessment scores were higher in foot ulcer patients. Poor foot care practices were observed in patients with diabetic foot ulcer patients.Conclusion:Diabetic foot ulcers were more common in elderly males. Peripheral neuropathy, peripheral vascular disease, Smoking, trauma, duration of diabetes mellitus and high levels of glycated haemoglobin had significant association with occurrence of foot ulcers. MNSI scores had a high predictive value for development of foot ulcers amongst diabetics. Awareness regarding foot care was poor which underlines need to promote practice of foot care amongst diabetic population.
INTRODUCTIONParagangliomas are relatively rare endocrine tumours that arise from paraganglionic tissue, a widely dispersed collection of specialized neural crest cells. In the absence of histological diagnosis and symptoms of catecholamine excess, paragangliomas may be mistaken for GISTs. Approximately, 50 cases of non-functional retroperitoneal paragangliomas were reported in the literature. We report a case of paraganglioma of the duodenum, which emphasizes the necessity to include extra-adrenal paraganglioma in the differential diagnosis and management of retroperitoneal tumors.
Lipoma is a universal benign tumour which is uncommon in foot and especially in sole region. It should be considered in the differential diagnosis of foot lesions. A case of lipoma of heel of five years duration in a 48 years old housewife is described in which FNAC was inconclusive. However findings of imaging studies suggested diagnosis of lipoma which was confirmed on histopathological examination of the excised mass. Literature has been reviewed emphasising rarity of site lesion.
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